A Multi-Centered, Two-Arm, Randomized Study Comparing the Effects of AAT-023 (Zuragen) Solution, and Heparin on the Incidence of Catheter Related Blood Stream Infections in Tunneled Chronic Central Venous Catheters for Dialysis

NCT ID: NCT00628680

Last Updated: 2008-03-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

415 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-07-31

Brief Summary

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The purpose of this study is to determine if AAT-023 (Zuragen) solution is superior to Heparin in preventing Catheter Related Blood Stream Infections for End Stage Renal Disease patients.

Detailed Description

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The purpose of this study is to show that AAT-023 (Zuragen) Solution is superior to Heparin in preventing Catheter Related Blood Stream Infections (CRBSI) when used as a catheter lock solution in Central Venous Catheter's for Dialysis between hemodialysis treatments (3x per week), where CRBSI's are defined as concordant bacteria found in both the catheter and peripheral blood or the exit site and peripheral blood in subjects demonstrating a temperature greater than 38 degrees celcius.

Conditions

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End Stage Renal Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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AAT-023 (Zuragen Arm)

Active experimental consisting of AAT-023 (Zuragen)solution

Group Type EXPERIMENTAL

AAT-023 solution (Zuragen)

Intervention Type DEVICE

Amount equal to the catheter lumen plus 0.3mL. Three times per week (after each Hemodialysis) for 26 weeks

Heparin

5000 units diluted with normal saline to the exact catheter lumen volume

Group Type ACTIVE_COMPARATOR

Heparin

Intervention Type DRUG

Hepaarin 5000 units diluted with normal saline to the exact catheter lumen volume.

Interventions

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AAT-023 solution (Zuragen)

Amount equal to the catheter lumen plus 0.3mL. Three times per week (after each Hemodialysis) for 26 weeks

Intervention Type DEVICE

Heparin

Hepaarin 5000 units diluted with normal saline to the exact catheter lumen volume.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. End Stage Renal Disease 18 yrs or older.
2. CVCD with average dialysis flow rate over 300 mL/min for three most recent visits.
3. Expectation by Investigator that CVCD may be needed for up to 26 weeks.
4. Dialysis catheter is of three types a) single body with single entry and exit, b) single body with split ends, c) twin catheter with one catheter for removal of blood and another for return.
5. Kt/V \>1.1 or equivalent URR
6. Negative serum pregnancy unless surgically sterile or post menopausal for \>1yr.
7. Negative blood culture result from pre-enrollment blood sample draw.
8. Ability of patient to sign and understand the informed consent.
9. Most recent lab results don't indicate hypocalcemia (\<7mg/dL) or thrombocytopenia (\<20,000)
10. Avg. systolic blood pressure \>90 mmHg as measured during the most recent three dialysis treatments.
11. Lack of signs of current blood stream infection at the beginning of the prior three dialysis treatments.

Exclusion Criteria

1. A known Heparin allergy or a history of type 2 (antibody mediated) Heparin-induced thrombocytopenia.
2. Active bleeding from any site or a documented positive stool hemocult test within 28 days of enrollment in study.
3. Bloodstream infection,exit site infection or any infection requiring antibiotic use within 14 days of enrollment for any antibiotic listed in section 4.2.3 or within 30 days of enrollment for Vancomycin or any other antibiotic not listed in section 4.2.3 of the protocol
4. Inability to comply with the conditions of, or complete the protocol in the opinion of the Investigator.
5. Pregnant or breast feeding.
6. Documented allergy to sodium citrate, methylene blue, methyl/paraben and/or propyl paraben.
7. Documented chronic intrinsic coagulopathy evidenced by persistently and significantly elevated Prothrombin (INR\>3), Partial Thromboplastin Time (PTT\>60 seconds), or thrombocytopenia (platlet count \<20,000/mm).
8. Malignancy requiring chemotherapy or radiation treatment within 180 days of enrollment.
9. Documented requirement for \>5,000 units of Heparin per catheter lumen to maintain catheter patency (with decrease in blood flow demonstrated at 5,000 units per lumen Heparin catheter lock) with current catheter.
10. Contraindications to citrate or taking drugs that may interact with citrate.
11. Documented history of glucose-6-phosphate dehydrogenase deficiency (G6PD or Drug-induced methemoglobinemia).
12. Participation in another research study.
13. Co-morbidities, such as HIV, active hepatitis or recent transplants, that in the opinion of the Investigator, may increase the risk associated with study participation or may interfere with the interpretation of study results and would make the subject inappropriate for entry into this study.
14. Unknown priming volume of catheter lumens.
15. Redness of over 1 cm diameter or pus around the catheter exit site.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ash Access Technology

INDUSTRY

Sponsor Role lead

Responsible Party

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Ash Access Technology

Locations

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Western New England Renal & Transplant Associatea

Springfield, Massachusetts, United States

Site Status

Henry Ford Hospital

Detroit, Michigan, United States

Site Status

Hypertension & Renal Research Group

Buffalo, New York, United States

Site Status

Bayview Nephrology, Inc.

Erie, Pennsylvania, United States

Site Status

Kidney Associates, PLLC

Houston, Texas, United States

Site Status

Southwest Houston Research, LTD

Houston, Texas, United States

Site Status

Fox Valley Nephrology Associates

Appelton, Wisconsin, United States

Site Status

Bakersfield Dialysis Center

Bakersfield, California, United States

Site Status

Renal Medical Associates

Lynwood, California, United States

Site Status

Nephrology & Hypertension Associates, PC

Middlebury, Connecticut, United States

Site Status

Brandon nephrology

Brandon, Florida, United States

Site Status

Gulf Breeze Dialysis Center

Dunedin, Florida, United States

Site Status

Bayonet Point Hudson Kidney Center

Hudson, Florida, United States

Site Status

Outcomes Research International, Inc.

Hudson, Florida, United States

Site Status

Bay Breeze Dialysis

Largo, Florida, United States

Site Status

New Port Richey Kidney Center

New Port Richey, Florida, United States

Site Status

Discovery Medical Research Group

Ocala, Florida, United States

Site Status

Nephrology consultants

Orlando, Florida, United States

Site Status

Hernando Kidney Center

Spring Hill, Florida, United States

Site Status

Nephrology Associates, P.C.

Augusta, Georgia, United States

Site Status

MId Atlantic Nephrology Associates, PA

Baltimore, Maryland, United States

Site Status

Caritas St. Elizabeth Center

Boston, Massachusetts, United States

Site Status

Countries

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United States

References

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Maki DG, Ash SR, Winger RK, Lavin P; AZEPTIC Trial Investigators. A novel antimicrobial and antithrombotic lock solution for hemodialysis catheters: a multi-center, controlled, randomized trial. Crit Care Med. 2011 Apr;39(4):613-20. doi: 10.1097/CCM.0b013e318206b5a2.

Reference Type DERIVED
PMID: 21200319 (View on PubMed)

Other Identifiers

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AATML2003-A

Identifier Type: -

Identifier Source: org_study_id

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